The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 42 SARGENT STREET 4/30/2018 42 SARGENT STREET 210/018.0-0056-0000.0 1 Date. J,s r TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING 40 CHU This certifies that . flit'L. . . .f l . . . . . ... . . . has permission to perform . . % 'S plumbing in the buildings of . . .V'oj.�.V . . . . . . . . . . . . . . . at . .'Xd. . ,,��j./t�z', .r ..r-7. . . . . . . . . . . .. North Andover, Mass. Fee. .a.0. . .Lic. No.. . . . . .�� . PLUMBING INSPECTOR Check „* Y MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:-VOI�WAOLAR, ---, MA. Date:42,6/11 —_ Permit# Building Location: _s _�� _ Owners Name: � �. Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No FIXTURES � N z w co N CJ Q N O H m OIX LU LU W V U) N W W Lu O z Z O tY H D W O Q O ? w N w m 0 O o, cn U ZLU W Lu cn O ~ w y p a = v a LU z LU >- z tD J W I— O w O z 0 F- I- ~ H H I•I w 0 Lu LU SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR 7 1H FLOOR 8TR FLOOR � �4 ------------ Check One Only Certificate# Installing Company Name: Address: /��,, El Corporation S►l1Yd1 W(�kCity/Town:IAWAOi-- State: i -E]Partnership Partnership Business Tel:ALq1JR0�U-L-- Fax:--------------- --------- Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes❑ No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massac s General Law that my signature on this permit application waives this requirement. Cher One Only _— Owner ❑' Agent ❑ Si nature o wner.or Owner's nt By checki g this box❑;I here a 'fy that of the details and information I have submitted(or entered)regarding this application are true and accurate o e best of my K wl dge at all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinen vision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ---- ❑Plumber Title--_—___ ❑Gas Fitter Signature of Licensed Plumber/Gas Fitter ❑Wster _ City(fown _ _ Journe man License Number: Y APPROVED OFFICE USE ONLY ❑LP Installer — -- 76 b i_ Date. .... .... r j. L N°RTM o? TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION h SACH This certifies that . J .Z: . . . �cX 4 7`W— v. . . . . . . . . . . . r // has permission for gas installation . . . N-4 4 in the buildings of . . ss 7�. . . . . . . . . . . . . . . . . . . . . . . . . . at . . ]]. . . .t� . . . . . . . North Andover Mass. <' Fee. Lic. No.. /7771. . . . . . GAS INSPECTOR Check#_�� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:�IQ -1aV , MA. Date:-0/4/ Permit# Building Location: Ljp _5 � �� Owners Name: UJ��fi� -lG �f "� Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential EK New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ETI ,FIXTURES z z N O Y U i W z J = W to o0.. W z H Y v) Q Q cn O Qz � to z z 9 a w y ~ w z 0 Y to � 0 a X a N w o I•- z W 0 9 W z W (nz t) a LL Q U. 0 1– z Z Q � z a Y a x w w W uWI0 x a Q m m O G = ° Q 0. .� z Y > O a a a H g o- fn to l– 0 SUB BSMT. BASEMENT 15T FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6TIF- FLOOR 7 FLOOR -i'FLOOR Check One Only Certificate# Installing Company Name: ❑Corporation Address:23S "V__54' -City1Town:�� '4-_ State: ------ �Fiarrm ership Business Tele= �� Fax: / - /Company —_—_ Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes❑ No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massa sett Genera w s,and that my signature on this permit application waives this requirement. Chec ne Only Owner Agent ❑ Sig natur of ner or Ow f's a t— I hereby certify that all of tKe/dep&ils a d information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbi COVand installations performed under the permit issued for this application will be in compliance with all Pertinent provision 111I Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By-- -- -- Type of License: �_--------------- Title_ --_--_ ❑Plumber Signature of Licensed.Plumber City/Town ❑ sterL-jJourneyman License Number: APPROVED OFFICE USE ONLY – FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS) • FEE: $ PERMIT# APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING SKETCH PLUMBER LICENSE NUMBER: PERMIT GRANTED❑ DATE: PLUMBING INSPECTIOR. 1 y •r f � w -pi�1►�Z0.!��+EALTH OF Q.- SS ACKUSE'i TS IN PU LICENSED ASA JOURNEYMAN PLUMB ISSUES.THEE ABOVE LICENSE TO' mi LESLIE A CASTRO , ' 235 BROADWAY ST R 28MA 01840-1036 LAWRgNCE 30199 05/01./12 784244 _~ , ----- ""! r Location qlN4 No. nZ v Date �oRTN TOWN OF NORTH ANDOVER O } Certificate of Occupancy $ it SA�N�s<t' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0 g. 15843 A A( �� / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING -777 7777 :, `-•: a ,'1 1$ Ql'®1l iCi1 �$C;6, BUILDING PERMIT NUMBER. DATE ISSUED: SIGNATURE: C Building Commissioner/In ctor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record �Aa 57ira l+ arae(Print) Address for Service { Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Mn Address- . Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name M Registration Number r Address r Z Expiration Date Signature Telephone Y, SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a licable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other Specify rV C4 Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE:=ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e) X (b) 4 Mechanical HVAC a Of 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB j SIZE OF FLOOR TINMERS in 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS 11I.IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover Building Beartment • 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta .� � _ Building Commissioner . (978) 688-9545 978 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please prim DATE 1OB LOCATION `Aa umber ireet Address / IOMEOWNER Map lot Name Home Phone W�Phone ESENT MAILING ADDRESS75 , City Town State ZP Code The current exemption for"horn of two units or less and.to allow such home ended to include ef�upied dwellings not possess a license ever ac to engage an individualloe Aire v► does Provided that the owner acts as supervisor (State Budding Code fir► 108.3.5.1) DEFINITION OF HOMEWCfWNER Persons)who owns a Parcel a land on which there is, or is intended heYshe resides or tends to on which to'be, a one or two family dwelling.attached or reside cessory to such use andu /or fan structur , A person who detached s nstnxts bt�ctures ac- two-year period shall not be-considered a homeov�+ner. MOM UM"One home Ina The undersigned "homeowner assumes r Applicable codes b ��nssibility for mance withthe Stale Building Code and other Y-laws, rotes and r The undersigned "homeowner certifies that he/she and Building Department minimum ins action understands the Town of No.An �pIY with said procedures and requirements and requirements and that he/she wit! ' 'IOMEOVVNER'S SIGNATURE 'PROVAL OF BUILDING OFFICIAL NoK � M Town of Andover No. / 3L LOCH C �,�` dover, Mass., DRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ' R ! BUILDING INSPECTOR THIS CERTIFIES THAT..... ................................... ....... ../Q. V Z ..0................ .............. Foundation V I�V l ............. .~... � 1� ' .. . Rough has permission to erect......... ............................ buildings on , �. ............................ . . ... S � �N to be occupied as I 4 ��. ................ Chimney ............ ...........�.................V................. provided that the person accepting this permit shall in every respect conform to 1--terms of the application on file in Final this office, and to the provisions of the Codes and By-Law reaming to the Ins pe ion, Alteration and Construction of Buildings in the Town of North Andover. 19 y � 161 C) PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR CRough .............. .... .................................................. Service 11BVA UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. Location �a No. _ Date TOWN OF NORTH ANDOVER # Certificate of Occupancy $ 1'�s''•° Ec�' Building/Frame Permit Fee $ s�cNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� 0o Check # 15661 vbuilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT PPLICATION.TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING MDING PERMIT NUMBER. DATE ISSUED. /r Y (� a .GNATURE: Building Commissioner aor of Buildings Date :CTION 1-SITE INFORMATION 1.1 Property Address: 1.2. Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ning District Proposed Use Lot Area Frontage it i BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided Water Supply M G.LC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: { ,is ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ ,CTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Owner of Record me(Print) • Address for Service • `U i 7a nature L Telephone Owner of Record: J ame Print L Address for Avice/l o"(4-c- lature Telephone hone CTION 3-CONSTRUCTION SERVICES t Licensed Construction Supervisor: Not Applicable ❑ j V/�L Zif1w :used Construction Supervisor: U Q yd/ 1 �f�� _ License Number ress �1 ;1O'—O Expiration Date ature Te ephone j 2egistered Home Improvement Contractor Not Applicable 0 0.00 j arm ,�G�StG > pany Name / G 2�6/ 7 ; S -- W .0 17'7 4' Registration Number r 1 1 I 0 ag� Expiration Date tture Telephone I i E ' SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �a�,►� jai,. I SGL f 2D�/�' ��--.�,� ��zfc,� J�•� �.�/r�s� 1�ays,� /Zo�t: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item, Estimated Cost(Dollar)to be Completed by permit applicant_ 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing .Building Permit fee(a)x(b) 4 Mechanical AC 5 Fire Protection 6 Total 1+2+3+4+5 4 0 Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. ,as Owner/Authorized Agent of subject property , Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Si nature of Owner Date SECTIO1NN77b OWNER/AUTHORIZED AGENT DECLARATION ,as Owner/ .uthori d Age of subject property Hereby declare that the statements and information on the foregoing application are true.and accurate,to the best of my knowledge and belief IVa ,%, 2 7-'J- Print e Signature of Oe Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEMBERS 1sT 2ND 3 SPAN DIN ENSIGNS OF SILLS j DEVIENSIONS OF POSTS DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTINGX f MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND f IS BUILDING CONNECTED TO NATURAL GAS LINE Town . of 4 over . 0 .::. = :�. T Q - -L A E o - dover, Mas dZ COCHICHEWICK ADRATED 1"V S BOARD OF HEALTH PERM D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ..... • Foundation has permission to erect..................... ................. build! son .... . ... ...... . Rough to be occupied ..... ...................................... chimney ... .......... ..................................................................................................... provided that the person accept' this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ELECTRICAL INSPECTOR (� Rough ....................................................... ................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner • Street No. 1 SEE REVERSE SIDE Smoke Det. The Commonwealth of M*assachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: e /ZA-nk GA400�� Location: City 'Y &/Y 606(PI ' Phones (-`7 am a homeowner performing all work myself. =I am a sole proprietor and have no one working in any capacity am an employer providing wrkers'compensation for my employees working on this job. 00mpany name: IVAS QI" AvZY Cf/s ✓Tr/ Address 2 4 2 o>^•�G� s City: M/Lg P Phone*, - fJ�G- F suanjoe-Co. ?iiL4- .� CiaMMny name: Address r pity Phone* lnsq hone#- lnsuri + e.:-Co. Police► l=ai[wre to secure coaierage as n�uimd under mon 25A or WL 1.52 can testi taE6einlp Jon d criminal pen�lNes.d aflne up. to$1;500.00 and/or one yews'imprisonment as well as civa penalties in the form of a STOP WORK ORM and arm of($100 0Q)a day against understand that a copy of this statement may be forwarded to the Office of Investigations of the MA for coverage verification. !do herby certify der t pains titles of pedwl that the kAwmat!w provided above is bLe and correct Signature . v� g Date lam- -oZ. 1 Print name- U'/� Z /� Phone# - /3"- LJ ' Official use only do not write in this area to be completed by city or town official' Build D Building Dopt . . OCheck if immediate response is required Building Dept p Licensing Board El SQlectman's office Contact person: Phone#- D Health Department D Ofher W WORKMAR'S COMPENSATlOM North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: f 6-0or 90 5 � dL (Location of Facility) nature ermit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 0.9)* d ")f C"n A F)F0 V I I I I11, i 0 0;1 i C)I'l II0H1 CONIRACION • MEW E tI A-1\0 Rew"'If'11 loll Expi r�1 I io[I: 10246) V"a I. 0710212002 22(- [-.C)Wl'-*.Ll.— �>T type: Private Corporatio W1 L.(11 N G T 0 N IVIA NEW ENWAND Cusiom DESIGN, Vai Laola IT h LOUELL Sf. ADMINISMAT012 MINGTON Iip 01+.37 ............ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number..-,PS 008828 Birtbdtiite-.>. .j.ZQ 1�R511 Q4 Expire, 04/20/2004 Tr.no: 20132 I 9i Rest 'pt 00 VAL J LANZA 54 BIXBY ST REVERE, MA 02151 Administrator